The nurse is assessing a client suspected of having renal calculi who reports severe, wavelike pain that radiates down the thigh and to the genital area and a sensation of needing to void, but only small amounts are voided.
The nurse should explain which of the following information to the client?

"Stones that are lodged in the ureter cause symptoms like you are describing.”.

"You will most likely pass the stones in the next few hours.”.

"Your symptoms are consistent with stones that are lodged in the bladder.”.

"The stones will need to be removed through a procedure.”. .

Answer and Explanation

The Correct Answer is A

Choice A rationale

Ureteral stones cause severe, colicky pain that radiates to the groin or genital area. The ureter’s narrow anatomy can trap stones, causing obstruction. This obstruction triggers increased intrarenal pressure and ureteral spasms, producing waves of intense pain. Hematuria and urinary urgency with minimal voiding are common due to mucosal irritation or obstruction.

Choice B rationale

While small stones may pass spontaneously, predicting exact timelines is speculative. Passage depends on factors like stone size, location, and hydration. For stones larger than 5 mm, spontaneous passage rates decrease, often requiring intervention. Therefore, giving definite timeframes may misinform patients and delay appropriate care.

Choice C rationale

Bladder stones typically cause suprapubic pain, urinary frequency, and hematuria rather than radiating pain to the thigh or genital area. Bladder irritation may lead to dysuria or cloudy urine, but the described symptoms are more consistent with ureteral obstruction rather than bladder involvement.

Choice D rationale

Some stones do require procedural removal, especially those causing recurrent infections or obstruction. However, initial management includes conservative measures like hydration and pain control, reserving procedures for unresolvable cases. Early procedural focus may unnecessarily alarm the client or overlook noninvasive options.

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Correct Answer is D

Explanation

Choice A rationale

Avoiding exposure to cold climates is not specific to thalassemia prevention. While cold environments may exacerbate general vasoconstriction, they do not influence the genetic and hematologic basis of thalassemia symptoms.

Choice B rationale

Increasing fluid intake does not directly address thalassemia pathophysiology. While hydration is vital, it does not correct the primary anemia or the compromised oxygen delivery stemming from abnormal hemoglobin synthesis.

Choice C rationale

Iron and vitamin B12-rich foods are beneficial for conditions involving deficiency anemia. However, thalassemia involves a genetic defect in hemoglobin chains, so excess iron could even result in iron overload complications.

Choice D rationale

Medications and substances that exacerbate hemolysis, such as sulfonamides or antimalarials, should be avoided in thalassemia. Awareness and prevention of exposure are key to minimizing symptoms and complications in affected individuals. .

A. Monitor the client for signs of hemorrhage. B. Monitor the incision site for signs of infection. C. Monitor the client's urine for sand or gravel. D. Monitor the percutaneous nephrostomy tube for signs of obstruction.

Correct Answer is C

Explanation

Choice A rationale

Hemorrhage is not a typical complication of extracorporeal shock wave lithotripsy (ESWL), as it is a non-invasive procedure targeting kidney stones using shock waves. The risk of significant bleeding is minimal, and monitoring focuses more on urinary changes or localized pain rather than hemorrhage.

Choice B rationale

ESWL does not involve surgical incisions, so there is no incision site to monitor for infection. This action is irrelevant to the procedure's mechanism, which uses external shock waves to fragment stones rather than invasive surgical methods.

Choice C rationale

Sand or gravel in the urine is a common finding after ESWL as the procedure fragments kidney stones into smaller particles. These fragments are excreted through the urinary system. Monitoring urine for these particles helps evaluate the procedure's effectiveness and ensure stones are adequately eliminated.

Choice D rationale

Percutaneous nephrostomy tubes are used for urinary drainage but are not a standard component of ESWL. Monitoring for tube obstruction applies to invasive procedures, whereas ESWL focuses on non-invasive stone fragmentation. This action is unrelated to the client's current treatment modality. .

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The nurse is assessing a client suspected of having renal calculi who reports severe, wavelike pain that radiates down the thigh and to the genital area and a sensation of needing to void, but only small amounts are voided.The nurse should explain which of the following information to the client?

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Naxlex Comprehensive Predictor Exams

The nurse is teaching a client about preventing symptoms of thalassemia.Which of the following information should the nurse include in the teaching?

Correct Answer is D

Explanation

The nurse is caring for a client after receiving extracorporeal shock wave lithotripsy (ESWL). Which of the following actions should the nurse take?

Correct Answer is C

Explanation

The nurse has taught a client with urinary incontinence about managing the problem.Which of the following statements by the client would indicate the need for more teaching?

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The nurse is caring for a client who is in heart failure and weighs 176 pounds. The client is to receive prescribed dobutamine 10 mcg/kg/minute. The nurse has available 1,000 mg in 250 mL of 0.9% normal saline. How many mL per hour should the nurse administer to the client?

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The nurse is assessing a client suspected of having a lower urinary tract infection (UTI). Which of the following findings should the nurse expect?

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The nurse is assessing a client suspected of having renal calculi who reports severe, wavelike pain that radiates down the thigh and to the genital area and a sensation of needing to void, but only small amounts are voided.
The nurse should explain which of the following information to the client?